胰腺导管内乳头状黏液性肿瘤的CT及MRI表现

目的:探讨胰腺导管内乳头状黏液性肿瘤(P-IPMN)的CT及MRI特点。方法:回顾性分析15例经手术病理证实的P-IPMN患者的临床资料、CT及MRI表现。结果:15例中,腺瘤9例,交界性肿瘤2例,原位癌2例,腺癌2例。影像学分型及表现:主胰管型3例,主要表现为主胰管扩张伴胰腺实质萎缩,其中1例伴胆总管扩张,2例伴胰管内壁结节并中度强化;分支胰管型11例,其中6例位于体尾部,5例位于胰头及钩突部,病灶大小5 mm×6 mm~32 mm×40 mm,主要表现为单房或多房囊状肿瘤,似葡萄串,囊与胰管相通,其内分隔轻度强化,伴或不伴主胰管扩张;混合型1例,表现为胰腺体尾部多房性囊状肿瘤,可见病灶内多发性壁结节中度强化及分隔轻中度强化,伴主胰管明显扩张,直径22 mm。结论:P-IPMN有相对的影像学特征,CT和MRI对P-IPMN的诊断、鉴别诊断和恶性预测具有重要的临床应用价值。     

螺旋CT与DWI用于肺孤立性实性肿物良恶性鉴别诊断价值对比

目的探讨螺旋CT与DWI用于良恶性肺孤立性实性肿物鉴别诊断临床价值差异。方法收集肺孤立性实性肿物患者80例螺旋CT及MRI-DWI检查影像学资料,比较两种影像学检查方式用于肺孤立性实性肿物良恶性诊断准确率和良恶性病变ADC值。结果螺旋CT和DWI诊断肺孤立性实性肿物准确率分别为81.25%(65/80),96.25%(77/80);DWI用于良恶性肺孤立性实性肿物诊断准确率显著高于螺旋CT,差异有统计学意义(P>0.05);恶性肺孤立性实性肿物平均ADC值水平显著低于良性病变,差异有统计学意义(P<0.05)。结论相较于螺旋CT,DWI用于良恶性肺孤立性实性肿物良恶性鉴别诊断具有更佳准确率,可作为重要影像学辅助检查手段加以应用。     

能谱CT曲线斜率及碘浓度定量分析鉴别良恶性甲状腺结节的准确率观察

目的探讨能谱CT曲线斜率及碘浓度定量分析在良恶性甲状腺结节鉴别诊断中的应用价值。方法选取48例经超声筛查的甲状腺结节患者为研究对象,以病理检查结果为依据,分别纳入恶性组(n=21)和良性组(n=27);将同期入院行颈部检查的20例无甲状腺结节正常受试者纳入正常组(n=20)。两组受试者均使用能谱CT行能谱CT成像(GSI)单能模式平扫及增强扫描,后应用GSI Viewer软件计算碘浓度和能谱曲线斜率。记录并对比三组受试者计算结果差异;以病理检查结果为依据分析能谱CT检查对良恶性甲状腺结节的鉴别准确性。结果能谱CT正确诊断良性结节26例,正确诊断恶性结节19例,对良恶性甲状腺结节的鉴别诊断准确率为93.8%(45/48)。恶性组不同期相能谱曲线斜率及动脉期、静脉期碘浓度值检测结果均显著低于其他两组受试者(P0.05);平扫期内,良、恶性两组碘浓度值均显著低于正常组(P0.05),但两组对比无统计学意义(P0.05)。结论能谱CT在甲状腺结节的良恶性鉴别诊断中具有较高的准确率,临床可将其作为切实可行的影像学检查手段应用于诊疗工作中,为后续治疗方案的拟定提供条件。     

B超及CT检查女性盆腔疾患的比较研究

目的比较B超及CT检查女性盆腔病变的价值.方法回顾分析68例经B超及CT检查并经手术、病理证实的女性盆腔病变.结果CT检查女性盆腔恶性病变明显优于B超(P＜0.01);检查女性盆腔良性病变,B超与CT无明显差异(P＞0.05).结论检查女性盆腔恶性病变首选CT.对良性病变的检查作B超即可,如B超不能定性,则需作CT复查.     

肺部局灶性磨玻璃密度结节的MSCT征象分析

目的 回顾性分析肺部局灶性磨玻璃密度结节(focal ground-glass opacity,fGGO)的多层螺旋CT(MSCT)表现,以获得对诊断及鉴别诊断具有价值的影像学征象.资料与方法 分析66例经病理或抗炎治疗后证实的fGGO患者的基本临床资料、病灶大小、部位及MSCT表现,用x2检验、Fisher确切概率法、非参数Mann-Whitney U检验对比分析混合性磨玻璃密度(mGGO)与单纯性磨玻璃密度(pGGO)、良恶性fGGO之间是否存在差异,P＜0.05为差异具有统计学意义.结果 66例fGGO中,mGGO 53例,pGGO 13例;恶性48例,良性18例.对于基本临床资料、病灶大小、发病部位在mGGO与pGGO、良恶性fGGO之间差异均无统计学意义(P＞0.05).mGGO与pGGO的良恶性发病率差异无统计学意义(P=0.309).病灶形态(圆形/类圆形、不规则形)、边缘形态(分叶、棘状突起)、界面(清楚光整、清楚毛糙、模糊)、内部结构("空泡征")、邻近结构("胸膜凹陷征"、"血管集束征")在良恶性fGGO之间差异均有统计学意义(P＜0.05).结论 fGGO的MSCT征象:呈圆形/类圆形、分叶、棘状突起、清楚毛糙的界面、"空泡征"、"胸膜凹陷征"、"血管集束征"是诊断恶性的重要征象.     

MRI和CT及X线平片诊断良性骨病变侵袭征象的比较分析

目的 MRI、CT、X线平片诊断良性骨病变侵袭征象的比较分析。方法选取2014年5月~2017年3月间我院收治的良性骨病变患者220例,所有患者均通过X线平片进行检查,其中180例通过CT检查,110例通过MRI检查,三种方法都使用检查方法的患者90例,比较分析三种影像学方法的诊断和病理符合率。结果三种方式诊断良恶性骨病正确率和病理验证正确率相比,CT检查高于MRI检查,具有统计学意义(P0.05),三种影像学方式的联合使用,能够有效提升诊断正确率,与单一方式相比具有统计学意义(P0.05)。结论三种影像学方法综合使用,可以有效提高诊断的准确率。     

肺部混杂性磨玻璃密度结节的MDCT表现

目的 分析肺部混杂性磨玻璃密度结节(mGGO)的MDCT表现.方法 分析53例经病理或抗炎治疗后证实的mGGO的基本临床资料、病灶大小、CT值及MDCT表现(病灶形态、边缘形态、界面、内部结构、邻近结构),用χ2检验、Fisher确切概率法、非参数Mann-Whitney U检验分析良恶性mGGO之间是否存在差异.结果 53例mGGO中恶性40例,良性13例.对于基本临床资料、病灶大小及CT值在良恶性mGGO之间均没有统计学差异(P均＞0.05).病灶形态(圆形/类圆形、不规则形)、边缘形态(分叶)、界面、内部结构(空泡征)、邻近结构(胸膜凹陷征)在良恶性mGGO之间均存在明显差异(P均＜0.05).mGGO内GGO含量、实性部分和GGO的分界是否清楚在良恶性之间均没有统计学差异(P=0.507 vs 0.181＞0.05);mGGO内GGO含量在腺癌和细支气管肺泡癌2种病理类型之间也没有差异(P=0.726＞0.05).结论 mGGO的MDCT征象:圆形/类圆形、分叶、清楚毛糙的界面、空泡征、胸膜凹陷征是诊断恶性的重要征象.     

肺部局灶性磨玻璃密度结节MSCT诊断

目的 分析肺部局灶磨玻璃密度结节( focal ground-glass opacity,fGGO)的多层螺旋CT(MSCT)表现,以寻找对fGGO良恶性鉴别诊断有价值的影像学征象.方法 分析34例(40个)经病理或抗炎治疗后证实的fGGO患者的基本临床资料、病灶大小、部位、类型及MSCT表现,用Fisher确切概率法对比分析fGGO中细支气管肺泡癌(BAC)、非典型性腺瘤样增生(AAH)及良性三者MSCT表现之间是否存在差异,P<0.05为差异具有统计学意义.结果 40个fGGO中,混合性GGO(mGGO) 19个,单纯性GGO(pGGO)21个;BAC 27个,AAH 8个,良性5个.患者的性别、病灶形状在良恶性fGGO之间差异均无统计学意 义(P>0.05).mGGO与pGGO的良恶性发病率差异有统计学意义(χ2=10.506,P=0.003),17个mGGO为恶性结节.发病年龄、病灶大小、部位、边缘形态(分叶、毛刺、光整)、界面(清楚、模糊)、内部结构(细支气管征)、邻近结构(胸膜凹陷征)在BAC、AAH及良性病变之间差异均有统计学意义(P<0.05).结论 fGGO病灶边缘分叶、清楚的界面、细支气管征、胸膜凹陷征为MSCT诊断恶性fGGO的重要征象.     

多层螺旋CT灌注成像在肺结节鉴别诊断中的应用

目的 探讨多层螺旋CT灌注成像在肺结节的良恶性鉴别诊断中的价值.方法 采用多层螺旋CT机对96例肺结节患者行灌注扫描,其中良性结节18例、炎性结节28例、恶性结节50例.以perfusion 3软件测定结节的血流量(BF),血容量(BV),平均通过时间(MTT),渗透表面积乘积(PS)以及拟合时间-密度曲线(TDC),采用灌注参数及曲线形态来评价结节的良恶性.结果 BF、BV在炎性结节与良性结节之间具有显著性差异(P＜0.05),炎性结节均大于良性结节.MTT在三组结节之间没有显著性差异(P＞0.05),PS在恶性结节与良性结节之间、以及良性与炎性结节之间具有显著性差异(P＜0.05),恶性结节与炎性结节均高于良性结节,三组不同性质结节之间的TDC曲线形态也不同.结论 CT灌注成像能够较准确的判断肺结节的性质,在良恶性鉴别诊断中具有重要意义.     

多层螺旋CT与磁共振成像对胰腺导管内乳头状黏液性肿瘤的诊断价值比较

目的探讨和比较多层螺旋CT(MSCT)与磁共振成像（MRI）对胰腺导管内乳头状黏液性肿瘤（IPMN）的诊断价值。方法 回顾分析我院2017年2月至2022年6月间收治并经病理诊断为IPMN的43例患者资料，均行MSCT和MRI检查，参考病理诊断，比较两种检查结果。结果 MSCT、MRI对IPMN的病理诊断准确率均达到100%，两种检查结果对IPMN良恶性诊断、IPMN分型、病变部位、病变大小及有无壁结节等方面诊断一致性比例均相同。MSCT、MRI影像学检查结果显恶性肿瘤患者的病变最大直径>30 mm所占比例和有壁结节所占比例均明显高于良性肿瘤患者（P<0.05）;MSCT检查时间明显低于MRI检查时间（P<0.05）。结论MSCT、MRI对IPMN的诊断及良恶性鉴别的准确率较高，且二者诊断准确率差异无统计学意义，但MSCT的检查时间更短。临床应根据患者的具体情况选择适宜的影像学检查方法。     

Physiologic and pathologic calcifications and ossifications in the face and neck

The aim was to give a systematic presentation of physiologic and pathologic calcifications and ossifications in the face and neck with a special emphasis on clinical relevance. In a sometimes subacute setting one should recognize specific calcifications which often lead to important diagnoses such as fungal sinusitis or sclerosing labyrinthitis. In a more chronic situation intraocular calcifications in small children are pathognomonic for retinoblastoma. Juxtatumoral sclerosis of the laryngeal cartilage in laryngopharyngeal carcinoma is usually caused by tumor infiltration of the cartilage resulting in a higher tumor stage and, this way, has a major impact on the therapeutical strategy. Calcified lymph nodes are mainly unspecific but can be the result of tuberculosis or metastases of thyroid cancer. Cross-sectional imaging methods, most of all computed tomography, are ideally suited to reveal head and neck calcifications and ossifications, especially those which are clinically relevant.     

Head and neck infection and inflammation

This article discusses the imaging manifestations of infectious and inflammatory conditions of the head and neck. Special attention is paid to the sites, routes of spread, and complications of neck infections. Because the clinical signs and symptoms and the complications of these conditions are often determined by the precise anatomic site involved, anatomic considerations are stressed. Familiarity with the fascial layers, spaces of the neck, and the contents of each space is helpful for this discussion. The fascial layers of the neck are important barriers to infection, and once infection is established, the fascial layers play a part in directing its spread.     

幽门螺杆菌分泌与重组表达的VacA蛋白的分离纯化及其致细胞空泡效应与凋亡的对比研究

目的：分离纯化幽门螺杆菌分泌和重组表达的细胞空泡毒素抗原（ VacA）蛋白,并评价其致细胞空泡效应及致细胞凋亡效应。方法分别从幽门螺杆菌ATCC26695菌株培养上清和重组表达VacA蛋白的pQE30-VacA-E．coliM15基因工程菌中分离纯化VacA蛋白,经酸化后,以不同终浓度（5,10 ng／ml）分别与人胃腺癌AGS细胞共孵24 h,观察致空泡效应,并通过流式细胞术检测细胞凋亡。结果成功分离纯化出幽门螺杆菌分泌和重组表达的VacA蛋白;幽门螺杆菌分泌的VacA蛋白能显著引起AGS细胞的空泡样改变及凋亡（P＜0．01）,而重组表达的VacA蛋白致细胞空泡样改变及凋亡不显著（ P＞0．05）。结论幽门螺杆菌分泌的VacA蛋白有良好的空泡毒性及致凋亡效应,而重组表达的VacA蛋白无致空泡及凋亡效应,幽门螺杆菌分泌的VacA蛋白可用于VacA作用机制的研究。     

化学和生物学融合对国际武器公约履约的影响

化学武器公约（ CWC）和生物武器公约（ BWC）是为禁止生产、发展、储存和使用化学武器和生物武器而制定的国际公约。近年来,科学技术快速发展,知识交叉渗透,学科之间出现整合和融合,促进了科技进步和经济发展。其中化学和生物学融合在有力促进制药、健康卫生、绿色化学和环境保护等产业进步的同时,也对化学和生物武器公约的履约产生了重要的影响。该文综述了与化学武器和生物武器公约相关的化学和生物学融合进展,并分析其对公约履约的影响。     

Oxygen uptake and ventilation during rowing and running in females and males

This study evaluated if the ventilatory response to exercise is impaired by the cramp position of rowing. Maximal oxygen uptake (VO2max), maximal expiratory volume (VEmax), and maximal heart rate (HRmax) during rowing and running were compared in 55 males (age, mean +/- SD, 21 +/- 3 years; height 176 +/- 5 cm; body mass 72 +/- 6 kg) and 18 females (age 20 +/- 2 years; height 164 +/- 5 cm; body mass 61 +/- 4 kg). VEmax was larger during rowing than during running (males, 157 +/- 16 vs. 147 +/- 13 L min(-1); 114 +/- 9 vs. 105 +/- 11 L min(-1), P<0.01). Also VO2max was larger during rowing than during running (males, 4.5 +/- 0.5 vs. 4.3 +/- 0.4 L min(-1); females, 3.3 +/- 0.4 vs. 3.2 +/- 0.4 L min(-1), P<0.01). However, HRmax was lower during rowing than during running (males, 194 +/- 8 vs. 198 +/- 11 beats min(-1); females, 192 +/- 6 vs. 196 +/- 8 beats min(-1), P<0.05). VEmax was correlated to body mass and fat-free mass, as was VO2max. Thus, the oxygen pulse (VO2max/HRmax) was larger during rowing than during running, while the ventilatory equivalent for oxygen (VEmax/VO2max) was similar. We showed that bending the body during rowing does not seem to impair ventilation either in males or in females. The results indicate that VEmax and VO2max relate to body size and fat-free mass for both females and males. The findings indicate that the involvement of more muscles, the entrainment, and the body position during rowing facilitates ventilation and venous return and lowers maximal heart rate.     

Old and dangerous: Prison and dementia

Older prisoners are the fastest growing group of prisoners in many countries. The purpose of this study is to explore the phenomenon of detention of persons suffering from dementia. Medline searches were conducted for relevant articles, chapters and books published until August 2016. Search terms included dementia, elderly, prison and criminal. Publications found through this indexed search were reviewed for further relevant references. As results, there is a lack of data about elderly with dementia in prisons. Given the rise in the average age, it is reasonable to hypothesize that the number of older prisoners is growing. Moreover, some elderly are imprisoned with a concomitant cognitive impairment or psychiatric disorder while others will develop such diseases once incarcerated. At the present time, legal and social systems seem unprepared to handle the phenomenon of dementia in prison. As proposal, health assessments for older first time offenders should become a practice inside the correctional facilities and include an evaluation for specific health issues, such as psychiatric comorbidity and cognitive impairment.     

Kidney and iodinated and gadolinium-based contrast agents

In patients with renal failure, iodinated contrast agents may cause acute deterioration of the renal function and gadolinium-based contrast agents (GBCAs) may cause nephrogenic systemic fibrosis (NSF). The administration of a contrast agent must thus be reviewed for each patient and evaluation of renal function is paramount even though its estimation using formulas derived from the creatinine level may fluctuate. For iodinated contrast agents, contrast induced nephropathy is reduced by hydratation, preferably intravenous, when the GFR is less than 60 ml/min. The risk for intravenous injections is less than the risk for arterial injections, and the GFR threshold may be reduced to 45 ml/min. For gadolinium-based contrast agents, patients at risk for NSF are those with end-stage renal disease and patients undergoing dialysis. In such cases, the injection of a gadolinium-based contrast agent is only considered after a risk-benefit analysis has been completed, an alternate linear or macrocyclic agent issued and the dose limited to 0,1 mmol Gd/kg. Recently, recommendations from US and European agencies have converged. Learning objectives: to be familiar with the risk factors of CIN with iodinated contrast agents; to be familiar with hydration procedures for patients at risk of CIN; to be familiar with the diagnostic criteria of NSF; to be familiar with the classification of GBCA with regards to the risk of NSF; to be familiar with the contraindications of the different groups of GBCA.     

Coracoclavicular and coracoacromial ligament calcification and ossification

Thirty-six patients with calcification or ossification at or around the coracoclavicular and coracoacromial regions were analyzed with regard to type, location, and configuration of the deposits and related clinical history. Calcification or ossification in the coracoclavicular region resulted largely from trauma (36%) or renal failure (28%). Trauma patients may develop punctate calcification or ossification but do not develop the tumoral type of calcification. About 5% of the renal failure patients had coracoclavicular ligament calcifications, one-half of which were of the tumoral type. Renal failure patients may have punctate or tumoral calcifications but do not develop ossification.